Key result
Non-invasive SpHb underestimates laboratory hemoglobin by ~1.4 g/dL in diabetic patients.
Why the study?
The accuracy and precision of non-invasive continuous haemoglobin concentration monitoring provided by the Masimo device in diabetic patients is poorly studied.
Does non-invasive continuous haemoglobin concentration monitoring accurately measure haemoglobin compared to laboratory values in diabetic patients?
Observational (n=14)
No
Does non-invasive continuous haemoglobin concentration monitoring accurately measure haemoglobin compared to laboratory values in diabetic patients?
Mean Difference: -1.37 (95% CI -1.51–-1.22)
Absolute Event Rate: 11.8% vs 13.2%
p-value: p=<0.0001
Non-invasive continuous haemoglobin monitoring in diabetic patients shows high correlation with laboratory values but significantly underestimates them with wide limits of agreement, limiting its clinical accuracy.
Cautions against relying on SpHb for transfusion decisions in diabetics; leaves open the need for device validation in this population.
Background Accuracy and precision of non-invasive continuous haemoglobin concentration (SpHb) provided by Masimo device in diabetic patients is poorly studied. This retrospective analysis aimed to provide data on SpHb accuracy and precision in diabetic patients. Results The sample size population consisted of 14 patients, with 56 SpHb/Lab data pairs. Lab value showed a mean ± standard deviation (SD) of 13.2 ± 1.2 g/dL, whilst SpHb showed a mean ± SD of 11.8 ± 1.1 g/dL. Linear regression analysis between Lab/SpHb data pairs showed a r of 0.8960 (CI95% 0.8281-0.9379, p value < 0.0001). SpHb underestimated the real Hb values provided by Lab. Bland-Altman analysis showed that SpHb accuracy was −1.37 g/dL (CI95% −1.51 to −1.22 g/dL, p value < 0.0001), precision of 0.55 g/dL, lower LOA −2.45 g/dL (CI95% −2.71 to −2.20 g/dL) and upper LOA −0.28 g/dL (CI95% −0.53 to −0.02 g/dL). Conclusions For the first time, we provided data on SpHb accuracy and precision in the diabetic population. SpHb showed a high correlation coefficient when compared with Lab values, but the wide LOA limits its accuracy.
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Rosa et al. (2022) conducted an observational in Diabetes mellitus in patients scheduled for elective open abdominal aortic aneurysm repair (n=14). Non-invasive continuous haemoglobin concentration monitoring (SpHb) vs. Laboratory haemoglobin measurement (Lab) was evaluated on Accuracy (mean bias) of SpHb compared to laboratory hemoglobin values (Mean bias -1.37 g/dL, 95% CI -1.51 to -1.22, p=<0.0001). Non-invasive continuous hemoglobin monitoring (SpHb) underestimated laboratory hemoglobin values in diabetic patients with a mean bias of -1.37 g/dL and wide limits of agreement.
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